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Flashcards in Neu 3 - Sleep Deck (35):

Alert, active mental concentration in which sleep stage it is? And what waveform EEG shows?

Awake (eyes open) and Beta (highest frequency, lowest amplitude).


Meditating, what is the sleep stage of this person and what waveform shows the EEG?

Awake (sleep closed), Alpha wave


Which stage is characterized by light sleep and Theta wave in the EEG?

Non-REM sleep: Stage N1(5%).


Non-REM sleep: Stage N2 (45%)

Deeper sleep; When bruxism occurs, Sleep spindles and K complexes.


Which sleep stage is characterized by sleepwalking, nightmares, and nocturnal enuresis and also Delta waves?

Non-REM sleep: Stage N3 (25%). Benzodiazepines decrease stage N3.


What does REM mean?

Rapid Eyes Movement.


What are the characteristics of REM sleep (25%)?

Loss of motor tone, increased brain O2 use, and variable pulse and blood pressure; when dreaming and penile/clitoral tumescence occur, EEG shows Beta waves.


Which structure of the brain produces the movement of the eyes in REM sleep?

PPRF (Paramedial Pontine Reticular Formation)


What do we see in EEG in Relaxation?

Alpha waves


What do we see in EEG in Stage N1?

Theta waves


What do we see in EEG in Stage N2?

Bruxism and Sleep spindles and K complexes.


What do we see in EEG in Stage N3?

Delta waves, sleepwalking and nocturnal enuresis.


What do we see in EEG in REM?

Beta waves, lose muscle tone and dreams.


Which are the most common sleep disorders?

Insomnia, Restless leg syndrome, Night terrors, Obstructive sleep apnea, Central sleep apnea, Narcolepsy and Nocturnal enuresis.


What types of restless leg syndrome exists?

Primary and secondary.


Which are the characteristics of night terrors?

Common in children, during the Non-REM slow-wave sleep (stage N3).


What is Narcolepsy?

Patients true from Awake to REM sleep and skip the others stages.


Which of the sleep disorders can not be diagnosed until 5 years of age?

Nocturnal enuresis.


What drugs can be used in nocturnal enuresis?

1)Imipramine: TCA, decreases stage N3, Short-term use only. 2)Desmopressin (DDAVP): orally, decreases urination. 3)Indomethacin: Decreases renal blood flow.


What is the benefit of using Melatonin for treatment of insomnia?

Non-addictive, OCT, vivid dreams, safe for


What is the benefit of using Valerian for treatment of insomnia?

OTC herbal remedy, studies show no benefit.


What is the benefit of using Antihistamines (Benadryl, Tylenol PM, Doxylamine) for treatment of insomnia?

Commonly used by patients first-line, associated with poor sleep quality, not for long-term use, anticholinergic side effects (avoid in the elderly).


What do we in the EEG in depression?

Decreases slow wave sleep and increases REM and REM latency.


Which are the sleep stages?

1)Awake (eyes open). 2)Awake (eyes closed).
3)Non-REM sleep (N1,N2 and N3). 4)REM sleep.


What is the benefit of using Trazodone for treatment of insomnia?

Antidepressant, increase REM sleep, small risk of priapism.


What is the benefit of using TCAs for treatment of insomnia?

Antidepressants, small risk of Arrhythmias (obtain EKG prior to use), anticholinergic side effects (avoid in the elderly).


What is the downside of using Long acting benzodiazepines (temazepan, lorazepam, clonazepam, diazepam, chlordiazepoxide) as treatment for insomnia?

Addictive, short-term only.


What is the benefit of using Zolpidem (ambien), zaleplon (sonata) for treatment of insomnia?

Act at the benzo receptor, short-term only.


What is the benefit of using Ramelteon (Rozerem) for treatment of insomnia?

Non-addictive because it works at melatonin receptors instead of GABA/benzo receptors; long-term studies are lacking.


What is the treatment for narcolepsy?

Avoidance of drugs that cause sleepiness, scheduled naps (once or twice a day for 10-20min), stimulants-modalities is first line, support group attendance, if cataplexy then use venlafaxine, fluoxetine, or atomoxetine, Sodium oxybate (GHB) can assist in sleep and reduce cataplexy.


What EEG waveforms correspond to the different stages of sleep?

Awake eyes open (Beta), Awake eyes closed (Alpha), N1 (theta), N2 (K complexes), N3 (Delta) and REM sleep (Beta).


What drugs are used to shorten stage N3 sleep?

Imipramine and benzodiazepines


What is the sleep pattern in a patient with narcolepsy?

Rapidly transition from the Awake state to REM sleep.


In what stage of sleep are night terrors found?

Non-REM sleep: Stage N3


How long does REM sleep occur?

Every 90 minutes